Case report: the malfunctioning implanted venous access device

Biofilm Related Infections: Is There a Place for Conservative Treatment of Port-Related Bloodstream Infections?

Vascular catheters are the most frequently used indwelling medical devices and have become necessary tools for patients with chronic or critical illness. Surgically or percutaneously placed venous access ports are used to facilitate long-term intravenous therapy. The widespread use of these devices has resulted in a dramatic increase in catheter-related infections. It implies considerable morbidity, occasional mortality, and an increase in medical costs derived from its diagnosis, treatment, and mainly, prolongation of the patient's in-hospital stay. Treatment of such infections is often difficult due to the presence of biofilms on the port inner surface; inside the biofilms, bacteria are less vulnerable to antimicrobial agents. Current diagnostic strategies are suboptimal, and most successful treatment options require removal of the infected device followed by a course of antimicrobial therapy. There are limited data concerning the efficacy of antibiotic treatment of port-related bloodstream infections without catheter removal.

Nurses' knowledge regarding the handling of the totally-implanted venous access device

In the light of nurses' questions regarding the handling of the totally-implanted venous access device, this study aimed to evaluate these professionals' knowledge. This is a descriptive study with a qualitative approach, whose sample was made up of 28 nurses working on the Internal Medicine ward and in the Emergency Room. The study was undertaken in two stages: interviewing, to evaluate knowledge regarding the handling of the implanted port; and an integrative review to clarify the doubts identified. The results indicated that the nurses' knowledge was inadequate regarding when to use the implanted port, its purpose, the puncture technique, maintenance and handling. It is concluded that the knowledge of the subjects evaluated is inadequate, and that it is necessary for these professionals' clinical skills to be standardized and for them to receive theoretical-practical training.

Transluminale Bergung intravasaler Fremdk�rper

Patients with central venous lines or implanted Hickman catheters and port systems, suffer catheter embolization in 0.1-2.8% of the cases due to material fatigue or medical malpractice. In a 58-year-old vascular surgery patient, a central venous line catheter fragment was successfully retrieved from the pulmonary artery using a snare catheter via a transfemoral approach. From this case, we discuss the incidence, clinical aspects, diagnosis and interventional therapy of catheter embolization.